Factors associated with patient exposure and environmental control during pediatric trauma resuscitation

Kelleher, Deirdre C.; Waterhouse, Lauren J.; Parsons, Samantha E.; Fritzeen, Jennifer; Burd, Randall S.; Carter, Elizabeth A.

doi:10.1097/ta.0b013e31827d5f9e

Cited by 2 publications

(2 citation statements)

References 29 publications

(20 reference statements)

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“…In contrary to other studies, exposure of patients (ie, fully undressing a patient) was performed frequently in our patient group. 14 In accordance to other studies, there are errors in specific items of the ATLS/PALS protocol, especially errors of omission, independently of patient age. 3,4 In the surgical study population, certain items in the ATLS protocol were frequently omitted as examination of the perineum and of the pelvis stability, log roll, and stabilization and examination of the whole spine (mainly the cervical part).…”

Section: Discussionsupporting

confidence: 84%

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Borns¹,

Ersch²,

Dobrovoljac³

et al. 2018

Pediatr Emer Care

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Objective In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. Methods Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed. Treatment adherence to advanced trauma life support guidelines and pediatric advanced life support guidelines and errors per patient were identified. Results During the study period, 128 patients were recorded (65.6% with surgical, 34.4% with medical diseases). The most common causes for admission were traumatic brain injury (21.1%), multiple trauma (20.3%), and seizures (14.8%). There was a statistically significant correlation between accurate handover from emergency medical service to hospital physicians and adherence to airway, breathing, circulation, and disability sequence (correlation coefficient [CC], 0.205; P = 0.021), existence of a defined team leader and adherence to airway, breathing, circulation, and disability sequence (CC, 0.856; P < 0.001), and accurate hand over and existence of a defined team leader (CC, 0.186; P = 0.037). Unexpected errors were revealed. Cervical spine examination/stabilization was omitted in 40% of admitted surgical patients, even in 20% of patients with an injury of spine/limbs. Conclusions Video recording is a useful tool to evaluate patient management in the pediatric resuscitation bay. Analyzing errors of missing the adherence to the guidelines helps to pay attention and focus on specific items to improve patient care.

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Section: Discussionsupporting

confidence: 84%

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Borns¹,

Ersch²,

Dobrovoljac³

et al. 2018

Pediatr Emer Care

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show abstract

“…Adherence to the ATLS protocol has been shown to improve outcomes for trauma patients, including decreased rates of morbidity and mortality . Skills learned in ATLS courses, however, decrease over time, and omissions from the protocol occur . Pediatric‐specific ATLS tasks such as weight estimation are also commonly omitted, particularly among teams who infrequently treat injured children .…”

mentioning

confidence: 99%

Effect of a Checklist on Advanced Trauma Life Support Task Performance During Pediatric Trauma Resuscitation

Kelleher

Carter

Waterhouse

et al. 2014

Academic Emergency Medicine

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Objectives: Advanced Trauma Life Support (ATLS) has been shown to improve outcomes related to trauma resuscitation; however, omissions from this protocol persist. The objective of this study was to evaluate the effect of a trauma resuscitation checklist on performance of ATLS tasks.Methods: Video recordings of resuscitations of children sustaining blunt or penetrating injuries at a Level I pediatric trauma center were reviewed for completion and timeliness of ATLS primary and secondary survey tasks, with and without checklist use. Patient and resuscitation characteristics were obtained from the trauma registry. Data were collected during two 4-month periods before (n = 222) and after (n = 213) checklist implementation. The checklist contained 50 items and included four sections: prearrival, primary survey, secondary survey, and departure plan.Results: Five primary survey ATLS tasks (cervical spine immobilization, oxygen administration, palpating pulses, assessing neurologic status, and exposing the patient) and nine secondary survey ATLS tasks were performed more frequently (p ≤ 0.01 for all) and vital sign measurements were obtained faster (p ≤ 0.01 for all) after the checklist was implemented. When controlling for patient and event-specific characteristics, primary and secondary survey tasks overall were more likely to be completed (odds ratio [OR] = 2.66, primary survey; OR = 2.47, secondary survey; p < 0.001 for both) and primary survey tasks were performed faster (p < 0.001) after the checklist was implemented.Conclusions: Implementation of a trauma checklist was associated with greater ATLS task performance and with increased frequency and speed of primary and secondary survey task completion.

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Factors associated with patient exposure and environmental control during pediatric trauma resuscitation

Abstract: Epidemiologic study, level III.

Cited by 2 publications

References 29 publications

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Effect of a Checklist on Advanced Trauma Life Support Task Performance During Pediatric Trauma Resuscitation

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